Chapter 129: The American Cancer Conference (5)
Doctor Moore had worked for the American Association for Cancer Research for thirty-seven years. He was going to retirest year, but he pushed back his ns to oversee the preparations for this years conference himself. It was because he was deeply inspired by Young-Joon.
Moore was also once a promising rookie who had sessfully made his debut in <em>Science. </em>He went on to be a professor at Brown University and a well-known scientist whose name appeared in many of Americas top newspapers. He was past his prime now, but he was once nominated for the Nobel Prize. He had studied cancer for over thirty years and seen countless scientists, breakthroughs, and new drugs. However, the progress being observed since Young-Joon appeared like aet was different.
Good morning, everyone, and wee to the Cancer Conference, Moore said as he presented Young-Joon.
It was a standard courtesy for the moderator to give a brief overview of the seminar speakers career before they began their lecture.
Doctor Ryu was personally invited by me. He has graciously agreed to give the first lecture on the first day of the conference to kickstart this event. As the person who was in charge of organizing this conference, I would like to express my deepest gratitude.
Moore then pulled up a small slide on the screen.
Im sure many of you already know about Doctor Ryu Young-Joon, but I would like to give you a brief introduction. I have brought with me three important statistics that can visibly demonstrate Doctor Ryus achievements.
Several graphs appeared on the screen.
These are data that was gathered by the American Association For Cancer Research. These are the statistics on the number of patients newly diagnosed with cancer each month.
Breast cancer: 240 000
Lung cancer: 200 000
Liver cancer: 85 000
Pancreatic cancer: 15 000
These data were gathered at the end ofst year.
Moore went on to the next slide.
Now, lets look atst months results.
Breast cancer: 310 000
Lung cancer: 240 000
Liver cancer: 125 000
Pancreatic cancer: 21 000
There is no way that the number of cancer patients increased so suddenly in just six months because there was a major change in human genes or lifestyle. So, how did this happen? Moore asked.
Diagnostic kits someone murmured.
Thats right. With themercialization of the diagnostic kit that Doctor Ryu developed about five months ago, cancer patients areing to the hospital and getting early diagnoses. People who would have otherwise not known they had cancer were diagnosed, said Moore. Lets look at the next one.
Breast cancer: 50 000
Lung cancer: 170 000
Liver cancer: 80 000
Pancreatic cancer: 40 000
This is how many patients die of cancer every month. These values were collectedst year. How has this changed?
Moore went on to the next slide.
Breast cancer: 48 000
Lung cancer: 170 000
Liver cancer: 2000 (Monthly average after theunch of Cellicure, the liver cancer cure)
Pancreatic cancer: 3000 (Monthly average after theunch of Birnagen, the pancreatic cancer cure)
The graph of monthly changes shown below this statistic was even more dramatic. The values for liver and pancreatic cancer dropped to less than one-tenth of the original value from June and July.
<em>p p p!</em>
As someone in the audience began pping, others followed.
Thest statistic is fascinating as well.
Alimap: $7800
Clutinib: $5200
Keraptin: $3800
Osimerzumap: $2900
Bevatinib: $7500
This was the average monthly cost of the conventional anticancer drugs. As we all know, this is not something the average person can afford to pay out of pocket without insurance.
Moore went to the next slide.
Now, it has changed to this.
Alimap: $9.70
Clutinib: $7.50
Keraptin: $3800
Osimerzumap: $8.50
Bevatinib: $7500
Wow
Everyone had heard the news, but seeing it this way came as a shock, even to the scientist who already knew.
A-Bios new nt-based pharmaceutical production method has yet to be applied to Keratinib and Bevatinib due to patent issues, so the price has remained the same, said Moore. However, the other three have gone down to almost less than 0.1 percent of the original cost. It is now the price of a burgerbo.
Moore turned off the slideshow and walked over to stand beside Young-Joon.
I believe these three statistics clearly show the things you are doing, Doctor Ryu. Youre finding patients who were undetectable before, youre saving patients who were previously untreatable by providing new technologies, and youre reducing the economic burden on society by bringing down the cost of drugs.
Moore finished up his introduction of Young-Joon.
I thank Doctor Ryu again for participating in todays lecture when you are doing such important work. Please give him a round of apuse.
<em>p p p!</em>
Once again, apuse filled the seminar room. Moore handed the microphone to Young-Joon.
Thank you, Doctor Moore. I dont think anyone in mypany has ever shown me such a well-organized statistic before. Can the A-Bio marketing team buy this data and use it? Young-Joon asked yfully.
There was mildughter in the audience.
Young-Joon presented the slide on dendritic cell-bypass chimeric immunotherapy.
What I am going to present today is my new paper, which is a technology thatbines Professor Kakegunis technology, the chimeric immunotherapy developed by Conson & Colson, and Cas9, which are gene scissors. It is called gene surgery.
Young-Joon began his lecture. All the scientists listened with interest, but their attention was all focused elsewhere.
<em>Will there be a discussion about the clinical patient at the end of this?</em>
The moment Forsberg was mentioned, the conversation could turn into a debate about immune checkpoint inhibitors. That was what everyone was worried and excited about at the same time.
... Ultimately working this way. Furthermore, a trial was done on an end-stage lung cancer patient in Sweden with hyperprogression.
Was that trial approved?
Someone threw a keen question at Young-Joon. It was Jamie Anderson.
Yes. The trial was approved by the Swedish Medical Product Agency.
And there was no animal data on this?
No. There was no animal testing done at the time.
So, you administered a new drug that hadnt been tested on animals directly to humans? Isnt that a bit risky?
...
Young-Joon stared at Jamie Anderson. Jamie Anderson was trying to put a dent in this technology; he was trying to get revenge on him for damaging the image of the immune checkpoint inhibitor.
It was a reasonable decision. Dendritic cell bypass, chimeric immunotherapy, and gene correction with Cas9: all three are well-established techniques. Trying them in the body all at once was the novel work being done.
Thats what I am saying. I mean, it just doesnt make sense to me that the Swedish Medical Product Agency would approve of a treatment that hasnt been pre-clinically tested for drug excretion or toxicity. Was there some kind of external pressure? Jamie Anderson attacked Young-Joon more tantly.
The patients condition was so severe that he only had about a week to live.
Just because they are a hopeless patient, it doesnt mean that you can test any new drugs on them like youre doing animal testing.
I agree. However, the patient insisted on this treatment, and the Swedish Medical Agency approved of the treatment because they recognized its potential.
Still, there is something called protocol in modern pharmaceutical practice
That is enough, Anderson!
Someone shouted from across the lecture room. Young-Joon wondered what scientist was brave enough to speak up, but to his surprise, it was a familiar face. Nichs, the CTO of A-Gen, was sitting in his seat with his legs crossed and a scowl on his face.
Protocols are important, but we dont have to getpletely hung up on them. That was a brave and wise decision made by the Swedish Medical Agency. And as for the hyperprogression that urred in the clinical patients body, wasnt that due to the immune checkpoint inhibitor that came out of yourb?
What!
Jamie Anderson scrambled to his feet with a frown.
Sit down, said Yoon Dae-Sung, the CEO of A-Gen, who was sitting beside Nichs. Doctor Anderson, is there a need to make such a disturbance at a conference this big?
...
Jamie Anderson red at Yoon Dae-Sung angrily, then sat back down. Young-Joon was a little baffled.
<em>Wait, when did those grandpase?</em>
Of course, they coulde as it was a big conference, but it was normal to send scientists rather thaning themselves. It was understandable for David and Nichs as David liked these kinds of things and Nichs was a scientist.
<em>But I didnt know Yoon Dae-Sung woulde.</em>
Young-Joon didnt recognize them as there were so many people in the seminar room and he had to get on stage right away.
<em>I should greet them after Im done.</em>
Young-Joon picked up the microphone again.
I will now exin the prognosis of the clinical patient.
He continued with his lecture.
* * *
About twenty minutester, Young-Joon finished his presentation and received another round of apuse.
Are there any questions? Young-Joon asked.
Dozens of hands immediately shot up from the audience.
You manipted a total of fourteen genes in immune cells in your paper. How many genes do you think can be manipted at most?
I believe we can manipte up to forty genes.
Originally, there were reports that chimeric immunotherapy worked well on blood cancers but rtively poorly on solid tumors. But you cured a solid tumor in lung cancer with the technology you developed, right?
Yes. And before that, it was used to cure liver cancer that had metastasized to the bone in a pediatric patient.
Then, do you believe that it will be effective on other types of cancers as well?
I predict so, Young-Joon replied.
More questions followed until finally, Young-Joon heard what he had been waiting for.
Doctor Ryu! a young, enthusiastic scientist asked. I know its a bit off-topic from your talk today, but you reported that immune checkpoint inhibitors have the potential to induce hyperprogression in a paper that came out around the same time, right?
Yes.
I was wondering if you could talk about that, at least briefly?
The look in everyones eyes changed. Jamie Anderson clenched his jaw.
I know that everyone is curious about that. We have data from an animal experiment and one clinical case, but science bes clear through countless repetitions, Young-Joon replied. However, I also believe that it is unreasonable to keep giving patients that risky drug and wait for hyperprogression.
Doctor Ryu! Jamie Anderson shouted. That drug has no possibility of hyperprogression. Do not speak about your own opinions that havent been peer-reviewed so recklessly.
Nichs interrupted again.
It happened to an actual patient!
Jamie Anderson turned and red at Nics.
Do you have any evidence that it was due to EGFR like Doctor Ryu ims?
There is a high probability of NSCLC having a mutation in EGFR!
Its just a high probability, not a proven fact!
But isnt that probability enough to reconsider administering it to patients in the future?
That drug was studied at the Cold Spring Laboratory for twenty years. It passed all clinical trial phases. I believe that there is nothing wrong with it. As the director of the Cold Spring Lab, I am sure of it.
... Then, A-Gen will have to be more careful about using drugs developed at the Cold Spring Lab from now on, Nichs said.
Doctor Nichs, you are the CTO of A-Gen, arent you? How can you say that so lightly?
Of course, I can. Doctor Ryu is an executive of A-Gen.
...
Jamie Anderson paused.
It is just like what Doctor Nichs said, Yoon Dae-Sung interjected, taking a deep breath. Doctor Anderson, Because Doctor Ryu is an A-Gen executive, the paper that Doctor Ryu published is also A-Gens paper. It is a legitimate criticism and a reasonable issue that could be raised in the scientificmunity. What would the pharmaceuticalpanies think if the developers of a new drug did not provide any feedback?
...
There was a heavy silence in the room. The air was so sharp and tense that someone could cut their finger on it.
Lets do this, Young-Joon spoke up again. I understand your position that mice experiments and one piece of clinical data are insufficient. It is a prominent new drug, so we should approach it carefully.
Young-Joon went on.
On thest day of this conference, I will demonstrate the process of hyperprogression caused by immune checkpoint inhibitors.
The scientists in the room looked confused. There were murmurs around the room.
How will we be able to see that with our own eyes? Are you going to inject the immune checkpoint inhibitor in the mouse, then take it out and measure the size of the tumor? Like you did in your paper? Jamie Anderson asked.
No, Young-Joon replied. If we cut open a rat, we can only see the size of the tumor at that moment. Its direct evidence, but I know you wont believe it because it would be a discussion only based on the result after the fact. And since there are a lot of different factors at y inside an organism, you could argue that its not because of the immune checkpoint inhibitor but because of other characteristics of the mouse.
Then what are you going to do?
I will show you the hyperprogression outside of the rats body. Not in pictures, but in videos. You will be able to watch the process of the tumor expanding explosively with your own two eyes, not just thest moment of the tumor.
...
The scientists were even more confused now. They all looked at each other like they didnt understand this nonsense.
Young-Joon smiled. His cell phone rang with a message from Cheon Ji-Myung.
[Weve attached an EGFR-mutant cancer cell to an organoid and created a mock tumor. The organoid has been treated, and you will be able to use it for your experiment in five days.]